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Nationwide rates for HCPCS A5514

For Diabetics Only Multiple Density Insert Made By Direct Carving With Cam Technology From A Rectified Cad Model Created From A Digitized Scan Of The Patient Total Contact With Patients Foot Including Arch Base Layer Minimum Of 3/16 Inch Material Of Shore A 35 Durometer (Or Higher) Includes Arch Filler And Other Shaping Material Custom Fabricated Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.42 / $34.47 / $39.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.13 / $33.42 / $46.32
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.08 / $56.78 / $98.43
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.75 / $30.75 / $44.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.60 / $35.60 / $35.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.99 / $34.40 / $43.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.60 / $26.98 / $43.56